A woman complained about the services provided by a general
surgeon and a private hospital. She consulted the surgeon regarding
elective surgery for varicose veins. At the pre-surgery
consultation she reported intermittent minor rectal bleeding. The
surgeon agreed to investigate the cause of her bleeding while she
was anaesthetised for her vein surgery. After performing the vein
surgery, the surgeon introduced a sigmoidoscope, which revealed a
polyp and a tumour in the rectal wall. He dissected the tumour from
the wall of the rectum, which resulted in a visible hole. He
repaired the hole.

The following day, he advised the woman that a tumour had been
found, dissected and sent for histological examination. Three days
later, she developed signs of peritonitis. She was returned to
theatre for repair of a leaking anastomosis and construction of a
stoma. When her condition did not improve, she was transferred,
later that day, to a major public hospital's department of critical
care. Three days later, she was transferred to a surgical ward and
had additional surgery the following day to excise a short length
of necrotic bowel and revise the colostomy.

It was held that the critical safety net of surgical and medical
back-up was not activated when the woman needed it. The hospital
did not provide the woman with care of an appropriate standard and
breached Right 4(1).

The surgeon's management of the woman's care was held to be
appropriate. He took into consideration his knowledge of the
patient when recommending that she have a bowel examination while
anaesthetised for her vein surgery. He advised her of the outcome
of the surgery and responded to her concerns. When he became aware
that the woman's condition had deteriorated and she required
additional surgery, he responded appropriately. He treated the
woman with reasonable care and skill and communicated with her
appropriately, and did not breach the Code.